Medical Marijuana: THC, CBD, Treatments And Access
First Published August 7, 2022
How THC and CBD Work
There are arguably three species of cannabis, namely Cannabis Sativa, Cannabis Indica and Cannabis Ruderalis. Of the three, Cannabis Sativa is the most common and is generally associated with the crops Hemp and Marijuana. Hemp has a tall cane-like appearance and is commonly grown for the production of industrial fibers and CBD extracts. On the other hand, marijuana is the female form of a smaller stock that has more branches and which grows flowers. The psychotropic properties of cannabis/marijuana make it popular with recreational users but also play an important role in the emergence of medical marijuana.
A versatile herb, cannabis has been specially grown for millennia to serve as medicine, food, industrial fiber and for spirituality. It thrives naturally in warmer climates. The earliest known records of medical marijuana use may be found in China and India’s ancient civilizations. Conditions treated included malaria, gastrointestinal diseases and rheumatism.
With such a chronicle, it would seem evident that cannabis earned its place as a most worthwhile drug. However, in the early 20th century, the herb became the subject of a deceptive campaign that led to its prohibition. Decades later, the medical value of cannabis is still shrouded in controversy. In order to dispel some of the misgivings, this article will delve into what medical marijuana really is. In addition, we will sift through the main active compounds – Tetrahydrocannabinol (THC) and Cannabidiol (CBD) – as well as some applications and access to the drugs.
Over 400 compounds are produced by the Cannabis plant
What is Medical Marijuana?
Medical cannabis or medical marijuana refers to the adaptation of any form of the cannabis plant to medically relieve symptoms of, or treat diseases and conditions. Recreational marijuana, on the other hand, may be defined as the casual use of cannabis for pleasure rather than for medicinal purposes.
There is no fundamental difference between herbal marijuana used for recreation and medical marijuana. They are made up of the same chemical constituents. Therefore, it is worthwhile to note that one may gain health benefits while smoking or otherwise using marijuana recreationally.
Well over 400 compounds are produced by the cannabis plant (see – Medical Marijuana: Medical Necessity vs Political Agenda). About 66 of them – called cannabinoids – are known to intercross with the endocannabinoid system of the human body. Research in 1992 revealed that in effect, cannabinoids from the plant readily bind to cannabinoid receptors that we naturally produce. Specifically, these interactions affect mind/body communication relating to pain, stress, sleep, immune function and more.
Delta-9 tetrahydrocannabinol (THC), Cannabidiol (CBD) and Cannabinol (CBN) are the three major active cannabinoids of the Cannabis plant. As such, they are the subject of countless medical research today. These cannabinoids will be discussed in detail below.
In the practical sense, medical marijuana is recognized as the administering of marijuana-derived drugs under the supervision of a physician to treat a diagnosed condition. Whether used in herbal form by itself, or as a complement to pharmacological medication, the objective is to attain a planned medical outcome.
THC vs CBD & Their Roles in Medical Marijuana
Drugs are usually extracted from the buds and leaves of either hemp or the marijuana plant.
Hemp consists of a comparatively high concentration of CBD which has anti-inflammatory properties. In contrast, marijuana contains a higher concentration of THC which can produce a sense of euphoria. However, cannabis can be hybridized to adjust the levels of THC and CBD, thereby modifying the properties. Within the United States, hemp (legalized in 2018) is classified as a cannabis plant with less than 0.3% THC, while marijuana is generally composed of more than 10% THC.
THC, CBD and CBN all interact with your body’s endocannabinoid system but the effects are not the same. To explain, CBD and CBN are non-intoxicating, while THC is the main psychoactive compound of marijuana. It binds to the biological cannabinoid receptors in the brain to give persons the “high” feeling, or in some cases, a feeling of sedation.
CBD added to a beverage
What is CBD?
CBD – Medicine without the “High”
Cannabidiol or CBD, the most abundant of the cannabinoids, has anti-inflammatory properties and currently attracts the most interest for medical applications. In particular, this compound has proven to be effective in the treatment of pain without having any major side effect.
Additionally, CBD is believed to have anti-anxiety effects along with the ability to counteract the psychoactive effects of THC. When extracted, it is easily isolated from THC so that patients can have the anti-inflammatory or relaxant benefits without any intoxicating effect. There is a form of child epilepsy called Dravet syndrome which has shown a real positive response to a strain of marijuana called Charlotte’s Web. Characteristically, this particular strain carries a high concentration of CBD.
While the pain reliving properties of marijuana may not be strong enough to stop the pain from a large wound, the herb has had considerable success in treating long-term chronic pain as in fibromyalgia and arthritis. As an option for such maladies, many over-the-counter CBD products are widely available in the form of oils and tinctures. They are also used as home remedies for nausea, acne, general pain, anxiety and other ailments. Of course, the use of cannabis products is subject to legal considerations.
THC can be extracted but many users smoke the plant
What are the Effects of THC?
THC – Medicine with potential for the “High“
Tetrahydrocannabinol or THC was first isolated as the main psychoactive compound in cannabis during research of the 1960s according to Onhealth.com. Explicitly, it is the chemical that causes the high sensation and its concentration determines the potency of certain medical marijuana drugs.
Usually, marijuana is smoked by recreational users for the “THC effect,” but it can also be ingested in food or taken in various other forms of medication. As medicine, THC has many of the same medical benefits as CBD and can relieve many of the same afflictions. In addition to treating pain, this chemical compound has proven to be most helpful to cancer patients, relieving nausea and loss-of-appetite, which are side effects of chemotherapy. Similarly, AIDS patients suffering from wasting syndrome have found a remedy in THC from marijuana – see Medical Necessity vs Political Agenda.
CBN – Antibacterial Agent
Cannabinol or CBN is one of the minor cannabinoids of the cannabis plant. It is a non-intoxicating compound that forms when THC is allowed to age and thereby becomes oxidized through exposure to air. Hence, old marijuana loses THC potency as it dries, while the concentration of CBN rises.
Dr. Emily Earlenbaugh wrote on the website leafly.com that Studies on CBN have found that it may be a potent antibacterial agent. It was reported to have been tested on strains of MRSA and found to be effective against this particular resistant strain of bacteria. The same article points out that in addition, CBN may also be a powerful neuroprotectant, appetite stimulant and treatment for glaucoma.
Cannabis Terpene Profile
Terpenes – Potential Sedative and More
Another important set of compounds found in marijuana are called Terpenes. It is from these aromatic compounds that the distinctive taste and smell of the plant are derived. About 200 Terpenes have been identified in the cannabis plant. They are secreted from the same glands that produce cannabinoids.
It is emerging that cannabis terpenes have notable medical value. In fact, Dr. Ethan Russo, a neurologist and psychopharmacology researcher, declared in an interview published on January 1, 2016, that when sedation results from using most of the common cannabis strains, it is actually attributable to a terpene known as Myrcene. Besides that, it is also believed that some terpenes may help to inhibit the activity and growth of cancer cells. For these reasons, they have become a part of medical marijuana research.
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Notable Applications of Medical Marijuana
Research in the 1980s and 1990s revealed a number of health benefits that can be derived from medical cannabis / marijuana. Indeed, several drugs and herbal remedies have been developed with many still in the pipeline
The following is a short list of conditions for which medical marijuana is notably applicable:
chronic pain
inflammation
anxiety
seizures
nausea
anorexia
depression
psychosis
muscle spasticity
asthma
glaucoma
low appetite
A more comprehensive list of the known uses and benefits of the cannabis plant will be detailed in an upcoming article. Please check back to read the many surprising facts.
It is undeniable that both CBD and THC have medical benefits and are considered safe when used under proper medical guidance. However, we must reiterate that marijuana used outside of medical guidance and supervision is not considered medical marijuana.
Medical Cannabis Drugs Profile
Researchers and drug companies have developed a number of medical marijuana products with varying concentrations of THC and CBD. Some of the prevalent ones are mentioned below, but please note that this is for general information only and not an endorsement of any product. You are advised to read our Disclaimer and Terms of Use.
Bedrocan: Bedrocan is made by a Dutch company of the same name. At least four other cannabis products made by this company are available in pharmacies by prescription. Bedrocan is composed of 22% THC and 1% CBD. Another of their products called Bediol consists of 6.3% THC and 8% CBD.
Aurora: Canadian company Aurora sells cannabis oils (and other products) under the same brand name. These products are marked by the CBD:THC ratio. The levels of the cannabinoids vary widely based on need. The Medical Marihuana Access Regulations of Health Canada regulate such products.
Sativex: Developed in the UK, Sativex is the trade name for a cannabinoid-based herbal formulation. It is prepared as a mouth spray to alleviate symptoms of multiple sclerosis, such as neuropathic pain, spasticity and overactive bladder.
Epidiolex (USA): According to the company’s website (accessed on May 1, 2022), “Epidiolex is the first and only FDA-approved prescription cannabidiol (CBD) to treat seizures associated with Lennox-Gastaut syndrome (LGS), Dravet syndrome, or tuberous sclerosis complex (TSC) in patients 1 year of age or older.” This drug was approved in 2018.
Note on Marinol and Nabilone: Approved by the FDA, these are not herbal drugs. Even though some persons may refer to them as medical marijuana, they are actually made of synthetic forms of THC. Marinol and Nabilone are meant to prevent nausea and vomiting in cancer patients receiving chemotherapy.
Thanks to Giphy
Making Cannabis Safe and Reliable for Medical Use
With the resurgence of marijuana as a source of medicine, regulations are needed to govern its cultivation, storage and processing. The plant must be grown under controlled conditions and strictly monitored. Further to that, definitive technical standards should be implemented in the production of drugs.
One of the dangers of smoking marijuana bought on the street is that it could have been improperly treated with pesticides, be infested with mold or be mixed with unknown substances. Such a situation obviously poses health risks. Safety and reliability are paramount in preparing the cannabis plant for use in medicine. To illustrate, thorough screening is required to detect and remove toxins and micro-organisms or any unwanted foreign matter. Extracts must be tested to determine the balance of the chemical components, potency and profile of the terpenes.
Oils are easily extracted from the cannabis herb with today’s modern technology, a fact that has important implications. When compared with directly using the leaves and buds, the processing of oils lends to greater precision in content and consistency. Again, this is vital to any consideration of medically applying marijuana, particularly as it relates to the appropriation of doses.
Given the reservations about cannabis, only end-products of the highest quality should be offered to the public as medicine.
Intake Methods: How Medical Marijuana is Taken
Doctors and patients now have the option of having medical marijuana dispensed as a stand-alone treatment for certain conditions or to supplement other medical therapies.
In particular, it has become indispensable to many who suffer severe side effects from pharmaceutical pain drugs.
As medicine, there are several options for assimilation or intake of marijuana extracts. These include:
topical oils, lotion, cream, gel and spray (mainly to treat pain)
transdermal (skin) patches
liquids for drinking or tinctures that are put under the tongue (especially for multiple sclerosis)
inhalation through a vaporizer that heats the herb and converts it to mist
bronchial inhalers for asthma / COPD
capsules and lozenges taken orally in the traditional way
edibles that are prepared by infusing cannabis in food such as cookies
smoking
Each intake method has a unique effect. Applying heat to the cannabis flower is the fastest way to activate the cannabinoids. With that in mind, those who smoke or vaporize marijuana tend to experience the upshot almost instantly. On the contrary, the effect of edibles is usually delayed, taking anywhere between 30 minutes and 2 hours for the euphoric feeling to set in.
Of course, smoking is generally not recommended by medical experts due to concerns about carcinogens in the fumes. Lung damage is an obvious risk. Moreover, one could not gauge the concentration of the cannabinoids nor maintain consistency from one cigar to another. It is believed that the true benefits of medical marijuana are best realized when more healthful delivery systems like capsules, liquids and patches are used.
Accessing the Benefits of Medical Marijuana
How to Get a Medical Marijuana Card
With the onset of partial legalization, the regulations differ in each nation or state as to how medical marijuana can be accessed. Generally, you must be suffering from a qualifying condition.
Such conditions are determined by the jurisdiction in which you live. With that, a written recommendation from a medical doctor must be issued. Note, however, that some doctors are not interested in recommending cannabis in any form. Another step may follow the doctor’s recommendation in some places. Specifically, you have to obtain a medical marijuana ID card. Finally, you can buy the drug at a dispensary.
In today’s world, people are aware of certain ardent rights. That includes access to all viable medicine. Indeed, they should never be denied the known health benefits of the cannabis herb, simply on the basis of others’ personal preferences.
It is encouraging, however, that with time, medical marijuana is gaining in acceptance. This is being driven by the availability of more credible information combined with high levels of advocacy in all parts of the world. This healing herb continues to show much promise in the treatment of a range of conditions including certain cancers and neurological disorders. In many instances, cannabis is being viewed as an important differentiator.
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References:
Clark, Peter A., Capuzzi, Kevin and Fick, Cameron. “Medical Marijuana: Medical necessity versus political agenda.” Medical Science Monitor. December 1, 2011. Retrieved 23 Nov. 2021 from
https://www.medscimonit.com/abstract/index/idArt/882116
Earlenbaugh, Emily. “What is CBN (Cannabinol) and what are the benefits of this cannabinoid?” Leafly. July 30, 2019. Retrieved 9 Nov. 2021 from
https://www.leafly.com/news/science-tech/what-is-cbn-and-what-are-the-benefits-of-this-cannabinoid
Holland, Kimberly. “CBD vs. THC: What’s the Difference?” Healthline. July 20, 2020. Retrieved 28 Oct. 2021 from
https://www.healthline.com/health/cbd-vs-thc
Mandal, Ananya MD. “What are Cannabinoids?.” News Medical. (2019). Retrieved 27 Apr. 2020 from https://www.news-medical.net/health/What-are-Cannabinoids.aspx
Moore, Melissa. “How the Endocannabinoid System was Discovered.” Labroots.
April 05, 2018. Retrieved 30 Mar. 2022 from
https://www.labroots.com/trending/cannabis-sciences/8456/endocannabinoid-system-discovered#:~:text=The%20discovery%20of%20these%20receptors,Devane%20discovered%20the%20endocannabinoid%20anandamide
Stone, Emma. “What are cannabis terpenes and what do they do?” Leafly. November 10, 2021. Retrieved 12 Apr. 2022 from
https://www.leafly.com/news/cannabis-101/terpenes-the-flavors-of-cannabis-aromatherapy
Ware, Mark A. “Medical Cannabis.” Encyclopaedia Britannica. Retrieved 4 Apr. 2022 from
https://www.britannica.com/science/medical-cannabis
“The Cannabis sativa Versus Cannabis indica Debate: An Interview with Ethan Russo, MD.” National Institutes of Health. January 1, 2016. Retrieved 24 Apr. 2022 from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5576603/
On Health. “What Is Pot? Medical Marijuana Laws, Uses, Safety”
(Reviewed By Charles Patrick Davis, MD, PhD on 9/15/2021)
Retrieved 11 Feb. 2022 from
https://www.onhealth.com/content/1/medical_marijuana
“Recreational.” Weedmaps. (2022). Retrieved 10 Feb. 2022 from
https://weedmaps.com/learn/dictionary/recreational
Weed Ed. “What exactly is medical marijuana, and how will Jamaica develop the requisite medical standards?”
The Jamaica Gleaner – Published October 10, 2018
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